Definition of cut-off hbv dna level between hbeag-negative chronic hepatitis b and inactive hbv carrier state in syria

Abstract EN

Background & Objection: The level of hepatitis B virus DNA correlates with histological liver damage in HBeAg- negative chronic HBV infection.

The aim of the study was to compare the single serum HBV DNA levels, when present, between two different states ofHBeAg-negative chronic HBV infection (disease and inactive carrier state) and in addition with the HBeAg-positive chronic HBV infection state.

Methods: Of 83 patients with chronic HBV infection (HBsAg-positive chronic carriers), 39 were inactive HBV carriers (HBeAg-negative, with normal ALT levels).

Another 34 patients had HBeAg-negative chronic hepatitis B (CHB).

These either had elevated ALT levels or a history of elevation twice or more during the previous year.

Finally there were 10 patients with HBeAg-positive chronic HBV infection.

Quantification was done using PCR- based assay.

Results: The differences in HBV DNA levels between the group of inactive HBV carriers (median 9,1 *lif copies/ml) on the one side and the patients with HBeAg-negative chronic disease (median 3,6*10* copies/ml) and with HBeAg-positive chronic HBV infection (median 7,3 copies/ml) on the other side were statistically significant (in both cases P=0.000).

The use of HBV DNA levels of 30 000 copies/ml as a cut-off to separate inactive HBV carriers from patients with HBeAg-negative CHB succeeded in classifying all cases, as 39/39 were below this level.

At the same time, 62% (21/34) of patients with HBeAg-negative CHB had levels higher than this cutoff.

Overall, it correctly classified 82% (60/73) of all HBeAg-negative patients.

Use of HBV DNA level of 20000 copies/ml as a cut-off classified 97% (38/39) of inactive HBV carriers below it, and 74% (25/34) of patients with HBeAg-negative CHB above it, or correctly classified 86% (63/73) of all HBeAg-negative patients.

Conclusions: Determination of HBV DNA level with PCR-based assay is a powerful tool to differentiate between patients with HBeAg-negative chronic HBV infection with or without disease.

A cut-off DNA level of 30 000 copies/ml separated all inactive carriers.

The use of a cut-off DNA level of 20 000 copies/ml correctly classified 86% of all HBeAg-negative patients in this study